Hokkoku Daiki, Akamaru Yusuke, Wada Noriko, Wada Ryohei, Ikeshima Ryo, Munakata Koji, Takiuchi Daisuke, Morimoto Osakuni, Ota Hirofumi, Shibata Kunitaka, Ohash Hirotsugu
Dept. of Gastroenterological Surgery, Ikeda City Hospital.
Gan To Kagaku Ryoho. 2019 Dec;46(13):2351-2353.
Gastroscopy ofa 79-year-old man complaining ofanemia showed a type 3 tumor at the lesser curvature ofthe gastric body. A biopsy revealed poorly differentiated HER2-negative adenocarcinoma. Abdominal CT showed the tumor at the lesser curvature ofthe gastric body, multiple lymph nodes with a maximum diameter of 25mm at the lesser curvature, and a mass measuring 50mm with ring enhancement on S6 ofthe liver. The clinical diagnosis was cT4aN2M1(Hep), cStage Ⅳ. He was treated with chemotherapy comprising 4 courses ofS -1 plus oxaliplatin. Although the tumor had shrunk remarkably, chemotherapy was discontinued because of anorexia. Therefore, we performed total gastrectomy and hepatic partial resection(S6). The final staging was ypT3N0M0, ypStage ⅡA. We achieved R0 resection, and he has shown no recurrence without adjuvant chemotherapy for 3 years.
一名79岁主诉贫血的男性患者接受胃镜检查，显示胃体小弯处有3型肿瘤。活检显示为低分化HER2阴性腺癌。腹部CT显示胃体小弯处有肿瘤，小弯处有多个最大直径为25mm的淋巴结，肝脏S6区有一个直径50mm的环形强化肿块。临床诊断为cT4aN2M1（肝），c期Ⅳ。他接受了包含4个疗程S-1加奥沙利铂的化疗。尽管肿瘤明显缩小，但由于厌食症，化疗停止。因此，我们进行了全胃切除术和肝部分切除术（S6）。最终分期为ypT3N0M0，ypⅡA期。我们实现了R0切除，他在未接受辅助化疗的情况下3年未复发。
